Tamización de cáncer colorrectal en población adulta asintomática: revisión sistemática

Objective: To identify the best strategy for colorectal cancer screening among population over 50 years of age. Methods: A systematic review was performed were main outcomes corresponded to colorectal cancer mortality and incidence as well as side effects os screening. MedLine, Embase, Cochrane, DARE, Clinical Evidence, CINAHL, LILACS and University of York databases were reviewed from January 1st 2001 to December 31th 2009. Results: The fecal occult blood test (FOBT) reduces colorectal cancer mortality about 20% to 33% but not the overall mortality (RR: 1.00, IC 95%: 0.98-1.01). There is no difference between annual (RR: 0.84, IC 95%: 0.78-0.90)or biennial FOBT screening (RR: 0.85, IC 95%: 0.78-0.92). Sigmoidoscopy, sigmoidoscopy plus FOBT, or colonoscopy are not supported on strong evidence (randomized controlled trials) as screening strategies for reducing colorectal cancer mortality. The evidence is controversial about performance of test guaiaco or immunochemical tests as FOBT screening tests. Conclusion: Based on the best available evidence FOBT should be used for colorectal cancer screening among population over 50 years.